The value of electronic medical record implementation in mental health care: a case study
Open accessAbstract
BACKGROUND: Electronic medical records (EMR) have been implemented in many organizations to improve the quality of care. Evidence supporting the value added to a recovery-oriented mental health facility is lacking. OBJECTIVE: The goal of this project was to implement and customize a fully integrated EMR system in a specialized, recovery-oriented mental health care facility. This evaluation examined the outcomes of quality improvement initiatives driven by the EMR to determine the value that the EMR brought to the organization. METHODS: The setting was a tertiary-level mental health facility in Ontario, Canada. Clinical informatics and decision support worked closely with point-of-care staff to develop workflows and documentation tools in the EMR. The primary initiatives were implementation of modules for closed loop medication administration, collaborative plan of care, clinical practice guidelines for schizophrenia, restraint minimization, the infection prevention and control surveillance status board, drug of abuse screening, and business intelligence. RESULTS: Medication and patient scan rates have been greater than 95% since April 2014, mitigating the adverse effects of medication errors. Specifically, between April 2014 and March 2015, only 1 moderately severe and 0 severe adverse drug events occurred. The number of restraint incidents decreased 19.7%, which resulted in cost savings of more than Can $1.4 million (US $1.0 million) over 2 years. Implementation of clinical practice guidelines for schizophrenia increased adherence to evidence-based practices, standardizing care across the facility. Improved infection prevention and control surveillance reduced the number of outbreak days from 47 in the year preceding implementation of the status board to 7 days in the year following. Decision support to encourage preferential use of the cost-effective drug of abuse screen when clinically indicated resulted in organizational cost savings. CONCLUSIONS: EMR implementation allowed Ontario Shores Centre for Mental Health Sciences to use data analytics to identify and select appropriate quality improvement initiatives, supporting patient-centered, recovery-oriented practices and providing value at the clinical, organizational, and societal levels.
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Canada has adopted mental health care quality measures in electronic medical records.
“In Canada, there has been the adoption of mental health care quality measures in electronic medical records 67 .”
From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [67]
In some countries with common claims datasets or electronic medical records, mental health care measures have been variably adopted.
“In some countries with common claims datasets or electronic medical records, mental health care measures have been variably adopted 66,67 .”
From Measuring and improving the quality of mental health care: a global perspective (2018) · cites this paper as [67]
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- Authors
- Riahi, S., Fischler, I., Stuckey, M. I., Klassen, P. E., & Chen, J.
- Affiliations
- University of Toronto (CA)
- Ontario Shores Centre for Mental Health Sciences (CA)
- Corresponding author
- Riahi, Sanaz
- Venue
- JMIR Medical Informatics
- Publisher
- JMIR Publications Inc.
- Published
- 2017-01-05
- Volume
- 5
- Issue
- 1
- Pages
- e1
- ISSN
- 2291-9694 (ISSN-L)
- PMC
- PMC5247622
- OpenAlex
- W2568042533
- Cited by
- 37
- References
- 23
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 7 · 2018: 5 · 2017: 2 · 2016: 1
- FWCI
- 7.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Medical Informatics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Nursing › Issues, ethics and legal aspects › Nursing Diagnosis and Documentation
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- electronic health records, mental health services, recovery-oriented care, quality improvement, medication administration, medication errors, adverse drug reactions, restraint minimization, schizophrenia, infection control, drug of abuse screening, clinical decision support, business intelligence, cost reduction, clinical workflow
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